A prospective comparative study of clinical profile and severity of plasmodium falciparum and plasmodium vivax in coastal Andhra Pradesh, India

Rukmini Ramya M., Rajya Lakshmi M.

Abstract

Background:Plasmodium falciparum (P.falciparum) causes vital organ dysfunction. The manifestation of severe form of falciparum malaria includes cerebral malaria, acidosis, severe anaemia, renal failure, hypotension, shock, disseminated intravascular coagulation and convulsion. Death rate used to be high. But vivax malaria is not presented in severe form and there is tendency of recurrence. Present study has been designed to compare clinical profile and severity of P. falciparum and Plasmodium vivax (P. vivax)malaria in coastal district of Andhra Pradesh.

Methods: Present study is a prospective comparative randomized observational study conducted in the depart of general medicine Rangaraya Medical College, Kakinada, Andhra Pradesh from February 2016 to May 2018. The study population include 260 patients diagnosed to have P. falciparum and P. vivax malaria and being admitted in the general medicine dept. Govt medical college Kakinada randomly selected based on exclusion and inclusion criteria.

Results: Out of 172 Falciparum malaria patients’ anaemia was present in 39.53% patient and out of 88 P. vivax patients 43.18% patients have anaemia. Thrombocytopenia was present in 19.76% patients of falciparum malaria and 79.54% of P. vivax. Increased leucocyte count was seen in 29.65% P. falciparum and 4.54% P. vivax patients. Leukopenia was seen in 9.3% P. falciparum and 1.136% P. vivax patient. PT and APTT was increased in 12.79% patients of P. falciparum malaria and 6.8% patients of P. vivax malaria. Liver enzyme was elevated in 27.9% of P. falciparum patients and 47.72% patients of P. vivax patients. Raised serum urea and creatinine, was seen in 18.60% patients of P. falciparum and 18.18% patients of P. vivax malaria. Electrolyte imbalance was also found in both groups.

Conclusions: - In present study number of falciparum malaria cases were more than vivax with male predominance. Hepatomegaly was more common falciparum, but splenomegaly was more common in vivax malaria patients. Anaemia and thrombocytopenia were more common in P. vivax malaria patients. Elevated liver enzyme was more common in P. vivax patients but elevated serum urea and creatinine was almost same in both groups. Except hepatic dysfunction all other complication was more in falciparum then vivax infection. Death was only marginally high in falciparum then vivax malaria patients.